Yuan Yingdi, Cai Zhiyong, Dai YaoYao, Hong Qin, Wang Xingyun, Zhu Lijun, Xu Pengfei, You Lianghui, Wang Xing, Ji Chenbo, Wen Juan, Guo Xirong
The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, Lianyungang, China.
Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, China.
Cell Physiol Biochem. 2017;43(4):1526-1532. doi: 10.1159/000481976. Epub 2017 Oct 16.
BACKGROUND/AIMS: Vitamin D deficiency has been shown to be associated with a greater prevalence of anemia in various healthy and diseased populations by a great deal of observational studies. However, less work has been done to explore this association in pregnant women. The aim of this study was to evaluate the association between maternal serum 25-hydroxyvitamin D [25(OH)D] concentrations and risk of gestational anemia in a large, nested case-control study.
The serum 25(OH)D concentrations was measured by enzyme immunoassay in 775 pregnant women affected with anemia and 1550 controls. Logistic regression analysis was conducted to assess the association of 25(OH)D concentrations with risk of gestational anemia.
We found the 25(OH)D concentrations was significantly lower in women affected with anemia than in controls. Logistic regression analyses showed that women with 25(OH)D concentrations < 25.0 nmol/L, from 25.0 to 37.4 nmol/L and from 37.5 to 49.9 nmol/L all had increased risk of anemia when compared with women with concentrations from 50.0 to 74.9 nmol/L. And the risk of anemia was significantly increased with the decreasing concentrations of the serum 25(OH)D in a dose-dependent manner (P for trend = 0.012). For women with concentrations < 50.0 nmol/L, they had an 80% increase in anemia risk (95% CI = 1.45-2.25) after adjustment for confounders. We also observed a nonlinear relationship between the serum 25(OH)D and anemia, with a threshold for 25(OH)D of 50.0 nmol/L existed for anemia.
Maternal serum 25(OH)D < 50.0 nmol/L may be a risk factor for gestational anemia, and it should be monitored for the high-risk pregnant women.
背景/目的：大量观察性研究表明，维生素D缺乏在各种健康和患病群体中与贫血的更高患病率相关。然而，在孕妇中探索这种关联的研究较少。本研究的目的是在一项大型巢式病例对照研究中评估孕妇血清25-羟维生素D [25(OH)D]浓度与妊娠期贫血风险之间的关联。
采用酶免疫法测定775例贫血孕妇和1550例对照的血清25(OH)D浓度。进行逻辑回归分析以评估25(OH)D浓度与妊娠期贫血风险的关联。
我们发现贫血女性的25(OH)D浓度显著低于对照组。逻辑回归分析表明，与25(OH)D浓度为50.0至74.9 nmol/L的女性相比，25(OH)D浓度<25.0 nmol/L、25.0至37.4 nmol/L以及37.5至49.9 nmol/L的女性患贫血的风险均增加。并且贫血风险随着血清25(OH)D浓度的降低呈剂量依赖性显著增加（趋势P = 0.012）。对于浓度<50.0 nmol/L的女性，在调整混杂因素后，她们患贫血的风险增加了80%（95%可信区间=1.45-2.25）。我们还观察到血清25(OH)D与贫血之间存在非线性关系，贫血存在25(OH)D的阈值为50.0 nmol/L。
孕妇血清25(OH)D<50.0 nmol/L可能是妊娠期贫血的一个危险因素，对于高危孕妇应进行监测。
